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HIV infection and bone disease

J Compston1

  • 1Dept of Medicine, Cambridge Biomedical Campus Francis Crick Ave, Cambridge CB2 0SL, UK. jec1001@cam.ac.uk.

Journal of Internal Medicine
|June 9, 2016
PubMed

Insights

Antiretroviral therapy improves HIV survival but increases fracture risk due to bone loss, especially early in treatment. Bone health assessment and interventions are crucial for aging HIV patients.

Area of Science:

  • Gerontology
  • Infectious Diseases
  • Bone Metabolism

Background:

  • Antiretroviral therapy (ART) has transformed Human Immunodeficiency Virus (HIV) infection into a manageable chronic condition, increasing life expectancy.
  • An aging HIV-infected population experiences a rise in non-AIDS comorbidities, notably osteoporosis and elevated fracture risk.
  • Fracture pathogenesis in HIV is complex, influenced by traditional factors and HIV-specific elements.

Purpose of the Study:

  • To highlight the emergence of osteoporosis and fracture risk in the aging HIV-infected population.
  • To discuss the multifactorial causes of fractures in individuals with HIV.
  • To recommend strategies for managing bone health in HIV patients.

Main Methods:

  • Review of current literature on HIV, aging, bone metabolism, and fracture risk.
  • Analysis of the impact of ART initiation and long-term use on bone mineral density.
  • Evaluation of risk factors contributing to fractures in HIV-infected individuals.

Main Results:

  • Significant bone loss is observed upon initiating ART, which tends to stabilize with long-term treatment.
  • HIV-associated osteoporosis and increased fracture risk are recognized comorbidities in the aging HIV population.
  • Fracture risk is multifactorial, involving both general and HIV-specific risk factors.

Conclusions:

  • Fracture risk assessment and bone mineral density measurement are recommended for HIV-infected individuals.
  • Lifestyle modifications to promote bone health should be advised.
  • Bisphosphonate therapy should be considered for HIV patients at high risk of fracture.

Keywords:
HIV infectionantiretroviral therapyfractureosteoporosis

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